TY - JOUR
KW - buprenorphine
KW - cannabis
KW - Comorbidity
KW - Legalization
KW - Methadone
KW - polysubstance use
KW - Recreational
AU - T. Rosic
AU - N. Sanger
AU - B. Panesar
AU - G. Foster
AU - D. C. Marsh
AU - L. Rieb
AU - L. Thabane
AU - A. Worster
AU - Z. Samaan
A1 - 
AB - BACKGROUND: As the legalization of recreational cannabis becomes more widespread, its impact on individuals with substance use disorders must be studied. Amidst an ongoing opioid crisis, Canada's legalization of recreational cannabis in October 2018 provides an important setting for investigation. We examined changes to cannabis use patterns in patients receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) following legalization. METHODS: This study includes cross-sectional data from 602 participants recruited 6 months pre-legalization and 788 participants recruited 6 months post-legalization, providing information on cannabis use. Regression analysis was used to estimate the association between legalization and cannabis use patterns. We collected longitudinal urine drug screens (UDSs) detecting cannabis-metabolites for 199 participants recruited pre-legalization and followed prospectively post-legalization. Conditional logistic regression was used to assess the association between legalization and UDS results. RESULTS: Past-month cannabis use was self-reported by 54.8 and 52.3% of participants recruited pre- and post-legalization, respectively. Legalization was not associated with changes in any measured cannabis characteristics: cannabis use (OR 0.91, 95% CI 0.73-1.13), days of use/month (B -0.42, 95% CI - 2.05-1.21), money spent, or cannabis source. There was no association between legalization and prevalence of cannabis use on UDS (OR 1.67, 95% CI 0.93-2.99) or percentage of cannabis-positive UDSs (OR 1.00, 95% CI 0.99-1.01). Participants overwhelmingly reported that legalization would have no impact on their cannabis use (85.7%). CONCLUSIONS: Amongst patients treated for OUD, no significant change in cannabis use was observed following legalization; however, high rates of cannabis use are noted.
AD - Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Medical Sciences Graduate Program, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Neurosciences Graduate Program, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Biostatistics Unit, Research Institute at St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.; Northern Ontario School of Medicine, 935 Ramsey Lake Rd, Sudbury, ON, P3E 2C6, Canada.; Canadian Addiction Treatment Centres, 175 Commerce Valley Drive West, Suite 300, Markham, Ontario, L3T 7P6, Canada.; ICES North, 41 Ramsey Lake Road Sudbury, Sudbury, ON, P3E 5J1, Canada.; Department of Family Practice, University of British Columbia and St. Paul's Hospital, 1081 Burrard St, Hornby site, Vancouver, BC, V6Z 1Y6, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Biostatistics Unit, Research Institute at St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Department of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. samaanz@mcmaster.ca.; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada. samaanz@mcmaster.ca.
BT - Substance abuse treatment, prevention, and policy
C5 - Measures; Opioids & Substance Use
CP - 1
DO - 10.1186/s13011-021-00372-z
IS - 1
JF - Substance abuse treatment, prevention, and policy
LA - eng
M1 - Journal Article
N2 - BACKGROUND: As the legalization of recreational cannabis becomes more widespread, its impact on individuals with substance use disorders must be studied. Amidst an ongoing opioid crisis, Canada's legalization of recreational cannabis in October 2018 provides an important setting for investigation. We examined changes to cannabis use patterns in patients receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) following legalization. METHODS: This study includes cross-sectional data from 602 participants recruited 6 months pre-legalization and 788 participants recruited 6 months post-legalization, providing information on cannabis use. Regression analysis was used to estimate the association between legalization and cannabis use patterns. We collected longitudinal urine drug screens (UDSs) detecting cannabis-metabolites for 199 participants recruited pre-legalization and followed prospectively post-legalization. Conditional logistic regression was used to assess the association between legalization and UDS results. RESULTS: Past-month cannabis use was self-reported by 54.8 and 52.3% of participants recruited pre- and post-legalization, respectively. Legalization was not associated with changes in any measured cannabis characteristics: cannabis use (OR 0.91, 95% CI 0.73-1.13), days of use/month (B -0.42, 95% CI - 2.05-1.21), money spent, or cannabis source. There was no association between legalization and prevalence of cannabis use on UDS (OR 1.67, 95% CI 0.93-2.99) or percentage of cannabis-positive UDSs (OR 1.00, 95% CI 0.99-1.01). Participants overwhelmingly reported that legalization would have no impact on their cannabis use (85.7%). CONCLUSIONS: Amongst patients treated for OUD, no significant change in cannabis use was observed following legalization; however, high rates of cannabis use are noted.
PY - 2021
SN - 1747-597X; 1747-597X
SP - 34
T1 - Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada
T2 - Substance abuse treatment, prevention, and policy
TI - Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada
U1 - Measures; Opioids & Substance Use
U2 - 33849580
U3 - 10.1186/s13011-021-00372-z
VL - 16
VO - 1747-597X; 1747-597X
Y1 - 2021
Y2 - Apr 13
ER -